# WILLIAMSVILLE WELLNESS PHP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WILLIAMSVILLE WELLNESS, LLC
- **Other names:** Williamsville Wellness Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1871965301
- **Legal business name:** WILLIAMSVILLE WELLNESS, LLC
- **Authorized official:** MR. ROBERT WOODROW CABANISS JR. (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (804) 559-9959

## Contact information

- **Practice address:** 10515 CABANISS LN, HANOVER, VA 23069-1840
- **Practice address phone:** (804) 559-9959
- **Practice address fax:** (804) 559-9613
- **Mailing address:** 10515 CABANISS LN, HANOVER, VA 23069-1840
- **Mailing address phone:** (804) 559-9959
- **Mailing address fax:** (804) 559-9613

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | 994 | VA | Yes |

## Other

- **Enumeration date:** 10/23/2015
- **Last updated:** 10/23/2015